Welcome

Welcome to the POZ Community Forums, a round-the-clock discussion area for people with HIV/AIDS, their friends/family/caregivers, and
others concerned about HIV/AIDS. Click on the links below to browse our various forums; scroll down for a glance at the most recent posts; or join in the
conversation yourself by registering on the left side of this page.

Privacy Warning: Please realize that these forums are open to all, and are fully searchable via Google and other search engines. If you are HIV positive
and disclose this in our forums, then it is almost the same thing as telling the whole world (or at least the World Wide Web). If this concerns you, then do not use a
username or avatar that are self-identifying in any way. We do not allow the deletion of anything you post in these forums, so think before you post.

The information shared in these forums, by moderators and members, is designed to complement, not replace, the relationship between an individual and his/her own
physician.

All members of these forums are, by default, not considered to be licensed medical providers. If otherwise, users must clearly define themselves as such.

Forums members must behave at all times with respect and honesty. Posting guidelines, including time-out and banning policies, have been established by the moderators
of these forums. Click here for “Am I Infected?” posting guidelines. Click here for posting guidelines pertaining to all other POZ community forums.

We ask all forums members to provide references for health/medical/scientific information they provide, when it is not a personal experience being discussed. Please
provide hyperlinks with full URLs or full citations of published works not available via the Internet. Additionally, all forums members must post information which are
true and correct to their knowledge.

A couple of weeks ago I felt a herpes outbreak coming on, but did not take any Valtrex at the time, (UK doctor recently took me off maintenance therapy, that I have pretty much been on since my HIV diagnosis). Unfortunately, this outbreak seems worse than normal. For a week now, I've been taking Valtrex, 5 to 6 pills a day (I think that's 2.5-3 grams/day) with no significant change. I'd like to take more to get this under control. How much Valtrex can you safely take? Is there any likelihood the virus is now resistant to Valtrex?

I use Acyclovir (Zovirax) that's proscribed at 3 or 4 times/day, if needed. They're 400mg tablets so I guess that's 4 grams, right? I needed them a few weeks ago and after the 1st day they cleared right up.

Cliff,For shingles you normally take 2 tablets 3 times a day - 6 500mg tablets = 3g per day.

I'm not sure that upping the dose now will help much. I know with shingles that you really need to start the Valtrex within the first 72 hours for it to be of much use as this is when the virus is most active.

From memory it is the same with herpes, you need to strike early to stop the virus in its active phase. You may have missed the boat this time. I did this with my first outbreak, not realising it was herpes, so the outbreak lasted for about 3-4 weeks and was very very intense.

Whenever I'm about to break out with herpes, I know it. My penis just starts to itch along the side. It's a very unique itch and from past experience I know exactly what it is. Fortunately, I have a bottle full of acyclovir (from May 04) and the minute I feel that itch, I'm taking the pills. Within 24 hours, it's gone.

anyone ever get shingles blisters on the sole of the foot? I can handle the leg pain and burning, but the foot blisters are driving me NUTS.I sit with my leg proped and ice packs on the bottom of my foot. What happens when the blisters pop? OUCH

With herpes, my attitude is maintenance or nothing. Treating an outbreak that has already started never seems have any noticeable effect at all; whereas, for me, I have never had a single outbreak whilst I have been on a maintenance regime.

Out of interest, why did you doctor stop you taking it as a preventative?

I've never heard of someone getting herpes on their foot. However, a blistery rash on the soles of the feet and/or palms of the hands could be secondary syphilis. I'd get your feet checked out by a doctor if I were you.

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

I spoke to my doctor about Valtrex as a possible treatment for HIV. The theory is that suppressing one virus might assist the body in fighting HIV.

However, the thought at Penn Hospital is that is at best a temporary treatment and that resistance to Herpes is indeed a possibility.

The idea of daily dose of Valtrex might be considered somewhat dubious. Long term results for folks with HIV may not have been studied. And with many folks, outbreaks subside with time.

I would do exactly what Anne said, and get to the doctor. Folks with HIV who are sexually active should be screened regularly for all testable STD's. I have a good friend who was suffering vision problems and it was later uncovered that he had syphilis, which behaved more aggressively and unusually because he is HIV positive. His doctor didn't test immediately because the symptoms were not indicative of syphilis, and it took him over a year to fully recover his vision.

So if your not responding to Valtrex, best to get professional advice as soon as possible.

I would do exactly what Anne said, and get to the doctor. Folks with HIV who are sexually active should be screened regularly for all testable STD's. I have a good friend who was suffering vision problems and it was later uncovered that he had syphilis, which behaved more aggressively and unusually because he is HIV positive. His doctor didn't test immediately because the symptoms were not indicative of syphilis, and it took him over a year to fully recover his vision.

Ris, I was directing my comments to Rob, who said he has blisters on his feet, which is a classic symptom of secondary syphilis. I once had a sensitivity reaction to an athlete's foot cream, which caused blisters on my feet. My doc insisted we test for syphilis, just to be safe. It wasn't syphilis, thank goodness. I stopped using the cream and the blisters went away.

anyone ever get shingles blisters on the sole of the foot? I can handle the leg pain and burning, but the foot blisters are driving me NUTS.I sit with my leg proped and ice packs on the bottom of my foot. What happens when the blisters pop? OUCH

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

I went off my prophylactic daily acyclovir once, and the outbreaks I subsequently had were horrendous - like yours, they seemed worse than "normal". It's like the herpes came back with a vengeance once it was no longer being suppressed and, like yours, it didn't seem to want to respond to the meds. I went back on the daily dose and haven't had any problems since then.

I had a long discussion with Tim Horn years ago, when I was first thinking of going the prophylactic route. I was worried about resistance, but he reassured me that it's very rare - pretty much unheard of. My only regret is that I didn't start sooner.

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

When I had been on acyclovir for a year I stupidly decided, without first speaking to my doctor, to see how I got on without it. Within a month I had the most viscous outbreak I've ever had. Treating the outbreak had no effect at all.

I spoke to my doctor about it afterwards and he pretty much said that this was exactly what he would expect and that he wouldn't even consider suggesting dropping the prophylaxis until I had been free of outbreaks for at least 3 years.

He also explained that whilst those on prophylaxis can, and regularly do, develop a limited resistance to acyclovir; the resistance isn't such that it tends to affect its effectiveness in suppressing herpes when used as a daily prophylaxis.

risred, Valtrex is only a prodrug version of acyclovir, which has been used extensively by HIV-positive patients for as long as any antiretrioviral drug has (in fact, it is an antiretroviral in its own right).

risred, Valtrex is only a prodrug version of acyclovir, which has been used extensively by HIV-positive patients for as long as any antiretrioviral drug has (in fact, it is an antiretroviral in its own right).

Thanks for catching that, Luke, and making me go back and re-read Risred's post because...

That's not usually true in people who also have hiv. I had herpes for seventeen years before hiv and the outbreaks did indeed subside to maybe one or two mild ones a year - until I became positive. Within a year or two of having hiv, I started getting more and more outbreaks until they were happening pretty much every two weeks and were getting increasingly bigger, more painful and longer-lasting. That's when I took the plunge and started prophylaxis. I know many other pozzies who had similar experiences.

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

I've been fortunate enough to to have my attacks reduce according to the "normal" pattern and rarely have an outbreak.

As it is a proper anti-viral, resistance, which is rare, is something that is in the back of the mind of at least some, and therefore should be used according to the need of the patient.

I have used valtrex for occasional outbreaks and it has worked well for me. My confusion with how its being promoted for daily use is linked to the fear based marketing plan for the product to induce folks to take it daily to prevent transmission.

Even rare resistance can ultimately be a real problem for all if the mutation is transferable. A non treatable virus ultimately can be a real cause of concern.

What you and your doctors decide ultimately should be custom to your needs of course. My intent is to share my conversation with my doctor and reflects the consensus thoughts of the U of P hospital. The question I asked my doctor was the connection to reports that using Valtrex may lower VL of HIV. Perhaps my doctors concerns were simply in that light, and not about treating chronic issues with Herpes. For that I apologize for not being clearer.

And as for screening "more regularly" for STD's, simply seems like good advice, as infections may take on non typical behavior patterns, or act more aggressively, or create environments for other infections to become more pronounced.

I think I had it on my foot but on the top not the sole. It came at the same time as a cold sore on my lip, was about the same size (very small). It didn't hurt but it looked almost identical to the oral sore. It took about a week longer than the oral sore to clear up. It hasen't returned.